Electronic Newsletter, Issue 407

January 7, 2014

AHRQ Stats

Between 1997 and 2011, the hospitalization rate for acute kidney failure had the steepest growth across all medical conditions, increasing by 346 percent. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #162: Most Frequent Conditions in U.S. Hospitals, 2011.)

Meditation programs – particularly mindfulness programs designed to focus attention and awareness on inner and outer experiences with acceptance, patience and compassion – are beneficial for reducing psychological stress, including anxiety, depression, and pain, according to a new research review from AHRQ’s Effective Health Care Program. An abstract of findings from the report was published January 6 in JAMA Internal Medicine. Meditation employs a variety of techniques to facilitate the mind’s capacity to affect bodily function and symptoms. However, according to AHRQ’s research review, there was insufficient evidence on the effect of meditation programs on stress-related behavioral outcomes such as positive mood, attention, substance use, eating, sleep, and weight. Stronger study designs are needed to determine the effects of meditation programs on improving the positive dimensions of mental health as well as stress-related behavioral outcomes. Complete findings can be found in the research review, “Meditation Programs for Psychological Stress and Well-Being.”

2. New AHRQ Toolkit Designed To Improve Safety of Fragile Newborns

A new guide, "Transitioning Newborns from NICU to Home: A Resource Toolkit," is available to help improve the safety of infants born preterm or with complex congenital conditions as they transition from the neonatal intensive care unit to their home. Funded by AHRQ, the toolkit features information on how hospitals can create programs in which a Health Coach serves as a teacher and facilitator who encourages open communication with the parents or caregivers to identify their needs and concerns and facilitate followup medical care for the infant by primary care providers. Using the toolkit, the Health Coach can customize a broad range of information for each family. Included are approximately 30 fact sheets, directed to either the clinician or the infant's family, on topics such as managing breathing and feeding problems.

3. New Review Evaluates Chronic Venous Ulcer Treatment Options

A new research review from AHRQ found that evidence is inconclusive for comparing benefits and harms of advanced wound dressings, systemic antibiotics, and surgical interventions to treat venous leg ulcers lasting 6 or more weeks in patients with preexisting venous disease. According to "Chronic Venous Ulcers: A Comparative Effectiveness Review of Treatment Modalities," additional clinical studies are needed. However, certain conclusions can be drawn from the available research. Antimicrobial dressings provide an advantage in improved healing, but evidence is insufficient about the effectiveness of antimicrobial dressings compared with each other or with compression alone. Collagen dressings may improve the proportion of ulcers healed versus compression alone, and allogenic bilayered human skin equivalents may promote more rapid healing, particularly among patients with long-standing venous leg ulcers, although this treatment did not affect post-treatment recurrence.

AHRQ will host a 1-hour Web conference on January 8, from 1:00 p.m. to 2:00 p.m. ET, on the use of TeamSTEPPS®, the Agency's teamwork training program, and what evidence is available to demonstrate the program's efficacy in improving patient safety. David Baker, Ph.D., TeamSTEPPS® master trainer and senior vice president at IMPAQ International, will discuss the following:

5. Registration Open for January 15 Webinar on Implementing Health Assessments in Primary Care

AHRQ is hosting a free Webinar on Wednesday, January 15, from 12:30 to 2:00 p.m. ET on the Agency's new guide to implementing health assessments in primary care. Richard Ricciardi, Ph.D., of AHRQ, and Douglas Fernald, M.A., of the Department of Family Medicine at the University of Colorado School of Medicine, will discuss the evidence-based guide for primary care doctors, nurse practitioners, and physician assistants on how to successfully select, adopt, and implement health assessments in primary care settings. The guide is titled "Health Assessments in Primary Care, A How-to Guide for Clinicians and Staff."

The latest issue of AHRQ's Health Care Innovations Exchange features three innovation profiles describing programs that aimed to increase rates of advance care planning. One featured profile describes a program that employed a nontechnical, nonthreatening approach to care-coordinator discussions about advance directives. The care coordinators, for example, introduced the topic by asking participants if they had chosen someone to speak for them about medical issues should they become unable to speak for themselves. The approach was targeted at low-income African Americans and black immigrants to encourage them to sign a living will and durable power of attorney for health care. It was later expanded to include members of all racial and ethnic groups. In a 6-month pilot test, the program increased the completion rate for advance directives among African Americans and black immigrants and reduced the gap in completion rates between these groups and whites. The AHRQ Health Care Innovations Exchange includes more than 50 innovation profiles and tools related to end-of-life care.